The most common mesothelioma treatments are surgery, chemotherapy, and radiation. These treatments can help patients live longer and with less pain. Some patients also access newer treatments through clinical trials. Veterans with mesothelioma can find the best treatments and doctors through the U.S. Department of Veterans Affairs (VA).
Video Summary: Registered Nurse Amy Fair explains what mesothelioma is, the causes, and the symptoms.
What is Mesothelioma?
Mesothelioma attacks the tissues that line most major organs, called the mesothelium. It is known mainly to attack the mesothelium of the lung, pericardial sack, peritoneal cavity in the abdomen, and also known to attack the lining of the testicles.
One of the first symptoms for developing mesothelioma is shortness of breath. A lot of times folks will have the shortness of breath with the pleuritic chest pain. This is also followed sometimes by substantial weight loss.
Many times after being diagnosed with mesothelioma your physician may ask you if you have been exposed to asbestos. Asbestos is a causative factor for mesothelioma. Some of the imaging studies may show underlying pleural plaques which are indicated that they have been around asbestos and may have underlying asbestosis.
The risk factors for developing mesothelioma are working around asbestos-related products, or being indirectly around those products such as secondhand exposures that are seen with wives that launder their loves ones’ clothes that have asbestos dust on them. So direct asbestos exposure, as well as indirect asbestos exposure, can be causative factors for mesothelioma.
If you have symptoms of mesothelioma of any asbestos-related disease, it’s important that you inform your doctor of your asbestos exposure so that appropriate testing can be done.
Medically edited and fact-checked by:Todd Gersten, MDDouble Board-Certified Oncologist and Hematologist
Malignant pleural mesothelioma forms in the lining of the lungs (pleura). It’s the most common form of mesothelioma and makes up 80-85% of all cases, so there are many treatments for it.
Surgeries for Pleural Mesothelioma
Surgery is most often used for patients with early-stage pleural mesothelioma as the cancer hasn’t spread to distant areas of the body.
There are two main surgery options: the extrapleural pneumonectomy (EPP) or the pleurectomy with decortication (P/D).
Extrapleural Pneumonectomy (EPP)
With an extrapleural pneumonectomy, doctors remove the lung closest to the cancerous tumors, the lining of the lungs (pleura), the lining of the heart (pericardium), and parts of the diaphragm.
Patients must be in good overall health to qualify for this surgical procedure as it is very aggressive. Patients may also face quality of life issues afterwards. For example, they may need to rely on an oxygen tank.
Pleurectomy With Decortication (P/D)
A pleurectomy with decortication removes cancerous tissue from the lining of the heart, the lung lining, and diaphragm. The lung itself is not removed.
Many oncologists (cancer doctors) prefer the P/D since it’s less intense of a surgery and spares the affected lung when compared to an EPP and has many of the same benefits.
Chemotherapy for Pleural Mesothelioma
Chemotherapy is one of the most common types of treatment for pleural mesothelioma. Most patients can receive a mix of two chemotherapy drugs: cisplatin and pemetrexed.
Chemotherapy may be used by itself or alongside other treatments. For example, doctors use hyperthermic intrathoracic chemotherapy (HITOC) after surgery. This can destroy microscopic mesothelioma cells that surgery couldn’t remove.
Amy FairRegistered Nurse
20+ years helping mesothelioma victims
“Chemotherapy is, for most people, intravenous. It goes in the vein. It goes through your whole system, [and] it kills your good cells and kills your bad cells.”
Also called radiotherapy, radiation is often used to shrink tumors and ease symptoms of pleural mesothelioma. It may also be used as a follow-up (adjuvant) treatment to kill cancer cells left behind after surgery. However, it’s not used in high doses as the side effects can be toxic.
Types of pleural mesothelioma radiation include:
External Beam Radiation Therapy (EBRT): This therapy allows doctors to shrink cancerous tumors without the need for surgery. According to the American Cancer Society (ACS), this is the most common type of radiation therapy used to treat mesothelioma.
Brachytherapy: With this therapy, a capsule with a radioactive material like iridium is put into the body near cancer tumors. It’s not normally used as a mesothelioma treatment, but it may be available in clinical trials.
Other Pleural Mesothelioma Treatment Options
Immunotherapy for Pleural Mesothelioma
Immunotherapy stimulates the body’s immune system so it can fight cancer cells more effectively.
In October 2020, the Food and Drug Administration (FDA) approved a combination of two immunotherapy drugs (Opdivo® and Yervoy®) for pleural mesothelioma patients.
Tumor Treating Fields for Pleural Mesothelioma
Tumor treating fields (TTFs) interrupt the growth of cancer cells using electrical pads that stick to the body.
The OptuneLua®, a TTF device made by Novocure®, was approved to treat pleural mesothelioma by the FDA in 2019. Current treatments combine chemotherapy with TTFs.
Peritoneal mesothelioma forms in the lining of the abdomen (peritoneum). This type of mesothelioma accounts for 10-15% of all cases.
The preferred peritoneal mesothelioma treatment is a combination of surgery and chemotherapy called cytoreduction with HIPEC.
This treatment comes in two parts:
Cytoreductive surgery: Doctors remove visible cancerous tumors from the abdomen lining and diseased abdominal lining with this debulking surgery.
Chemotherapy: After surgery, doctors bathe the abdominal cavity with hyperthermic intraperitoneal chemotherapy (HIPEC) — warmed up cancer-killing drugs.
Other treatments like radiation therapy may also be used in some cases. A doctor can recommend treatments for you based on how far the cancer has spread and other factors.
Treatment of Rare Mesothelioma Types
Mesothelioma can form in the linings of the heart or testicles in rare cases. These are known as pericardial mesothelioma and testicular mesothelioma. Thankfully, doctors can still treat these rare types.
Treatments for rare types mesothelioma include:
Pericardiectomy: This is a surgical procedure for pericardial mesothelioma. Mesothelioma inflames the heart lining and can cause the heart to work harder. Doctors remove some or all of the heart lining and cancer tumors to improve heart function.
Pericardiocentesis: This treatment is used in cases of late-stage pericardial mesothelioma. This treatment drains fluid from the heart lining using a catheter.
Orchiectomy: Used for testicular mesothelioma, this surgery removes one or both of the testicles to prevent cancer spread. Doctors may also perform a partial orchiectomy in some cases too.
Clinical Trials & Mesothelioma Treatments
More mesothelioma cancer treatments are now becoming available thanks to clinical trials. These trials are a form of cancer research as they test new treatments to see how effective they are. Past mesothelioma clinical trials led to new treatments like immunotherapy and TTFs.
Clinical trials currently test new treatments like:
Photodynamic Therapy: This treatment uses light to kill cancer cells with a light-sensitive medicine. It may also be used with other mesothelioma treatments like surgery.
Cryotherapy: An extremely cold liquid or spray is used to shrink cancer tumors. Dr. Robert Cameron, a top mesothelioma specialist, uses cryotherapy in qualifying patients along with other treatments.
Gene Therapy: Doctors can add genes to cancer cells to destroy them more easily, according to the ACS. It can be combined with other treatments like immunotherapy.
Patients who want to join a clinical trial should speak to their cancer care teams. Factors like the type of cancer someone has and how far it’s spread can affect eligibility.
Amy FairRegistered Nurse
20+ years helping mesothelioma victims
“I encourage clinical trials because they’re free, so you don’t pay for anything. But you’ve got to be a really good candidate, because if you’re very sick, it’s a long process. And sometimes you’re getting placebo, and sometimes you’re getting the actual drug.”
Our qualified nursing staff can help you access mesothelioma clinical trials. Call (877) 450-8973 to get started.
Palliative Mesothelioma Treatments
Not every cancer patient will qualify for life-extending mesothelioma treatments. That said, there are palliative cancer treatments still available to help patients manage their symptoms and reduce their pain.
Palliative treatments for mesothelioma include:
PleurX Catheter: Pleural mesothelioma patients often have pleural effusions (buildups of fluid within the lung lining). A PleurX catheter allows patients to drain fluid buildup without going to see a doctor.
Pleurodesis: This allows doctors to seal the lung lining to prevent fluid buildup. This can ease symptoms like shortness of breath and prevent the patient from having more pleural effusions.
Paracentesis/Thoracentesis: These treatments allow doctors to remove excess fluid from the lining of the lung or abdomen, respectively. Doctors insert a thin needle into the site where the fluid has built up and drain it.
Minor Surgery: Minor surgeries can be used to reduce the size of tumors and ease symptoms. These surgeries won’t help patients live longer, though.
Get a free veterans packet to learn about palliative care options.
There also may be alternative treatments available for patients with mesothelioma. They work to reduce stress and bolster general well-being. Patients also report many positive mental and physical health benefits.
Alternative treatments for mesothelioma include:
Meditation and breathing techniques
Although these methods may ease symptoms or stress, they are not a substitute for professional medical care. Talk to a doctor to see how alternative therapies can be used alongside mainline treatments.
How to Access Treatment for Mesothelioma Cancer
A mesothelioma doctor at a specialized cancer center can help patients get properly diagnosed and treated. It’s key to get treatments from a mesothelioma doctor since this cancer is so rare and very aggressive.
“It’s the most important thing in the world to go to the best doctor in the world for what you have.”
Mesothelioma doctors dedicate their time and experience to specifically help patients with this cancer. Veterans facing a mesothelioma diagnosis should know that the VA works with some of the top mesothelioma doctors in the country.
A top thoracic surgeon in Los Angeles, Dr. Robert Cameron provides veterans who have pleural mesothelioma with the most effective treatments. Like Dr. Lebenthal, he has decades of experience treating mesothelioma.
The Mesothelioma Veterans Center has no affiliation with and is not endorsed or sponsored by Dr. Robert B. Cameron. The contact information above is listed for informational purposes only. You have the right to contact Dr. Cameron directly.
Our team can connect you with top mesothelioma doctors right now. Find a doctor near you.
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Patients battling mesothelioma shouldn’t have to worry about how they’ll pay for treatment.
Thankfully, mesothelioma treatment centers can work with a patient’s insurance company to ensure all medical claims and costs are taken care of. This reduces the stress of dealing with medical costs directly.
Further, veterans and civilians with mesothelioma can pursue financial compensation to help pay for their medical care. Patients can access financial support programs through the VA and other avenues, including asbestos trust funds and legal settlements.
No. While there is not yet a cure for this cancer, there have been cases of patients who have entered mesothelioma remission and survived well past their projected life expectancy.
While average mesothelioma survival rates are fairly low, aggressive treatments may help patients live longer.
Are there any new treatments for mesothelioma?
Yes. New treatments for mesothelioma are being tested and researched all the time. They offer hope to patients when standard treatments don’t work.
The best way to access new mesothelioma treatment options is through clinical trials. Clinical trials study new treatments to help patients live longer or to better manage their symptoms. These trials follow strict mesothelioma treatment guidelines to keep patients safe.
What is mesothelioma life expectancy without treatment?
The life expectancy of a mesothelioma patient without treatment is around 4-12 months. This is because mesothelioma is aggressive and can quickly spread to lymph nodes and distant areas of the body.
How can veterans access mesothelioma treatments?
Veterans may be able to get mesothelioma treatments if they have VA Health Care. The VA Health Care program allows veterans to receive free or low-cost treatments from VA doctors.
Veterans can join this health care program when they apply for VA benefits if they’re not automatically enrolled.
Outside of VA Health Care, veterans can also use private health care insurance plans to get mesothelioma treatments from civilian doctors.
Double Board-Certified Oncologist and Hematologist
Todd Gersten, MD is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.
Dr. Todd Gersten is an independently paid medical reviewer.
Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.
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